Active NPI
Lakisha Moniq Shears, LCSW-C
- Clinical Social Worker
- Germantown, MD
National Provider Identifier
1629585245
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 20612
- Practice address
- 12774 Wisteria Drive
Suite 1001
Germantown, MD 20875-2087 - Phone
- (240) 200-4068
- NPI assigned
- Jan 4, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 20612 | MD | Primary |
Addresses
Primary practice location
12774 Wisteria Drive
Suite 1001
Germantown, MD 20875-2087
Mailing address
12774 Wisteria Drive
Suite 1001
Germantown, MD 20875
Phone (240) 200-4068
Other practice location 1
501 N Frederick Ave. Suite 300
Gaithersburg, MD 20877-1828
Phone (240) 200-4068
Other practice location 2
37 Neerwinder Court
Germantown, MD 20874
Phone (240) 370-9671
Other practice location 3
1327 Washington Blvd
Baltimore, MD 21230-1828
Phone (410) 396-6130
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20612 | MD | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1515024000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629417600000",
"number": "1629585245",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12774 WISTERIA DRIVE",
"address_2": "SUITE 1001",
"city": "GERMANTOWN",
"state": "MD",
"postal_code": "20875",
"telephone_number": "240-200-4068"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12774 WISTERIA DRIVE",
"address_2": "SUITE 1001",
"city": "GERMANTOWN",
"state": "MD",
"postal_code": "208752087",
"telephone_number": "240-200-4068"
}
],
"practiceLocations": [
{
"address_1": "501 N Frederick Ave. Suite 300",
"address_purpose": "LOCATION",
"city": "Gaithersburg",
"state": "MD",
"postal_code": "208771828",
"country_code": "US",
"telephone_number": "240-200-4068",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "37 Neerwinder Court",
"address_purpose": "LOCATION",
"city": "Germantown",
"state": "MD",
"postal_code": "20874",
"country_code": "US",
"telephone_number": "240-370-9671",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1327 Washington Blvd",
"address_purpose": "LOCATION",
"city": "Baltimore",
"state": "MD",
"postal_code": "212301828",
"country_code": "US",
"telephone_number": "410-396-6130",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHEARS",
"first_name": "LAKISHA",
"middle_name": "MONIQ",
"name_prefix": "Ms.",
"credential": "LCSW-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-01-04",
"last_updated": "2021-08-20",
"certification_date": "2021-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "20612",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Germantown, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.